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A New Report Looks at Nurse Migration in North and Central America as a Way to Strengthening Health Systems

March 5, 2013
N-211, 2012-13

International nurse migration is a multibillion-dollar global phenomenon. Historically, Mexicans and Central Americans have not played a significant part in the migration of nurses to the United States. A new report, Strengthening health systems in North and Central America: What role for migration?, sponsored by the Migration Policy Institute (MPI), seeks to draw attention to the cross-border migration in the Americas and suggests ways the migration could be managed to meet the demand for health care services in the region.

The report, co-authored by New York University College of Nursing’s (NYUCN) Allison Squires, PhD, RN, Assistant Professor and Deputy Director of NYUCN’s International Education & Visiting Scholars program and Hiram Beltrán-Sánchez of the Population Studies Center at Harvard University, focuses on nursing personnel in a comparative case study, which looked at health care services and human resources in five countries-- El Salvador, Guatemala, Honduras, Mexico, and the United States--to identify constraints on health care capacity.&nbsp;&nbsp; The report examines the health care sector in each country by reviewing their health care systems, demand for services, epidemiological profiles, and demographics.

“Using migration to meet health care demand is complex; it does, however, hold the potential for benefits to health care systems, economies, and patient outcomes,” Squires said. “Nonetheless, despite the perceived and actual difficulties, we advocate exploring and investing in its possibility because of the tremendous potential benefits for all kinds of patients and for ameliorating health disparities.”

The report, divided into sections, begins by providing general background information on the health care sector in each country. Section II explores the international, multibillion-dollar phenomenon of nurse migration and highlights the contributions of internationally educated nurses (IENs) to the US health care system. Section III reviews the major health care issues in each country, discussing how changing demographics and epidemiological profiles increase the demand for services and how nursing services can meet this new demand.

The report concludes with eight recommendations for fostering migration as a way to meet health care demand in all the study countries. These include investments in educational systems, ways to facilitate the credentialing of nurses across borders, developing visas based on improving language concordance between nurses and patients disproportionately affected by health disparities, integrating transitional educational programs as part of the credentialing process for internationally educated nurses, and ways to capitalize on “hidden nurses” of Hispanic heritage who are currently living in the United States who have the potential to contribute to health disparities reduction.

“In the long term, investments in nursing personnel are investments mainly in women and marginalized minorities,” Squires said. “These investments go toward reducing socioeconomic inequality, improving education and health care and improving overall population health profiles — to name just a few benefits. As our report shows, the current state of nursing personnel production in El Salvador, Guatemala, Honduras and Mexico clearly illustrates what happens when there is insufficient investment,” she said.

The authors would like to thank the New York University College of Nursing research assistants who contributed to this report at various stages: Lismarys Arjona, Katy Murtaugh, and Jamie Rose Carroll. The authors would also like to thank their respective universities for granting the use of their library resources to develop this report.

This research has been made possible through the generous support of the Tinker Foundation, the MacArthur Foundation, and the Open Society Foundations.

This report was produced for the Regional Migration Study Group convened by the Migration Policy Institute (MPI) and the Latin American Program of the Woodrow Wilson International Center for Scholars. The Study Group, a three-year initiative, is acting as a virtual think tank for policymakers and civil society officials in the United States, Mexico, and Central America who manage day-to-day migration relations and other issues related to human capital and global competitiveness.

About MPI: The Migration Policy Institute is an independent, nonpartisan, nonprofit think tank in Washington, DC dedicated to analysis of the movement of people worldwide. MPI provides analysis, development, and evaluation of migration and refugee policies at the local, national, and international levels. It aims to meet the rising demand for pragmatic and thoughtful responses to the challenges and opportunities that large-scale migration, whether voluntary or forced, presents to communities and institutions in an increasingly integrated world. Founded in 2001 by Demetrios G. Papademetriou and Kathleen Newland, MPI grew out of the International Migration Policy Program at the Carnegie Endowment for International Peace.

About New York University College of Nursing:
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing, a Master of Arts and Post-Master’s Certificate Programs, a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree.&nbsp; For more information, visit www.nyu.edu/nursing.